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Unilateral hemothorax in a 46 year old South Indian male due to a giant arteriovenous hemodialysis fistula: a case report.

Salim S, Ganeshram P, Patel AD, Kumar AA, Vemuri D, Jeyachandran V, Rajamanickam D, Shantha GP - Cases J (2008)

Bottom Line: Ultrasound guided aspiration revealed a hemorrhagic pleural fluid.Ligation of the fistula resulted in complete resolution of the hemothorax.The other possible causes for hemothorax in a dialysis patient are also discussed in this case report.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Medicine, Sri Ramachandra University, Chennai, India. shihas.salim@gmail.com.

ABSTRACT
In a patient undergoing regular hemodialysis through an arteriovenous fistula access, pleural effusion is a known long term complication. However, a unilateral hemothorax is relatively uncommon. Here we report a 46 year old male, end-stage renal disease patient, on maintenance hemodialysis, who presented with a giant brachiocephalic AV fistula in his left arm and progressive breathlessness. Radiological imaging revealed a left sided pleural effusion. Ultrasound guided aspiration revealed a hemorrhagic pleural fluid. A Doppler study of the fistula revealed a high velocity blood flow through the fistula, thereby establishing the cause of the unilateral hemothorax. Ligation of the fistula resulted in complete resolution of the hemothorax. The other possible causes for hemothorax in a dialysis patient are also discussed in this case report.

No MeSH data available.


Related in: MedlinePlus

Giant arteriovenous fistula. Photograph of the patient's upper body, with the left arm showing a giant arteriovenous fistula extending from the cubital fossa of the left arm up to the left supraclavicular area.
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Figure 1: Giant arteriovenous fistula. Photograph of the patient's upper body, with the left arm showing a giant arteriovenous fistula extending from the cubital fossa of the left arm up to the left supraclavicular area.

Mentions: Over the past year, the artificial AV fistula enlarged in size to attain its current dimensions (Figure 1). On 3rd June 2008, he presented to the emergency department of our tertiary care hospital with complaints of progressive breathlessness over the past 15 days. There was no history of associated chest pain, palpitations, syncope, cough, expectoration, or orthopnea.


Unilateral hemothorax in a 46 year old South Indian male due to a giant arteriovenous hemodialysis fistula: a case report.

Salim S, Ganeshram P, Patel AD, Kumar AA, Vemuri D, Jeyachandran V, Rajamanickam D, Shantha GP - Cases J (2008)

Giant arteriovenous fistula. Photograph of the patient's upper body, with the left arm showing a giant arteriovenous fistula extending from the cubital fossa of the left arm up to the left supraclavicular area.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2567296&req=5

Figure 1: Giant arteriovenous fistula. Photograph of the patient's upper body, with the left arm showing a giant arteriovenous fistula extending from the cubital fossa of the left arm up to the left supraclavicular area.
Mentions: Over the past year, the artificial AV fistula enlarged in size to attain its current dimensions (Figure 1). On 3rd June 2008, he presented to the emergency department of our tertiary care hospital with complaints of progressive breathlessness over the past 15 days. There was no history of associated chest pain, palpitations, syncope, cough, expectoration, or orthopnea.

Bottom Line: Ultrasound guided aspiration revealed a hemorrhagic pleural fluid.Ligation of the fistula resulted in complete resolution of the hemothorax.The other possible causes for hemothorax in a dialysis patient are also discussed in this case report.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Medicine, Sri Ramachandra University, Chennai, India. shihas.salim@gmail.com.

ABSTRACT
In a patient undergoing regular hemodialysis through an arteriovenous fistula access, pleural effusion is a known long term complication. However, a unilateral hemothorax is relatively uncommon. Here we report a 46 year old male, end-stage renal disease patient, on maintenance hemodialysis, who presented with a giant brachiocephalic AV fistula in his left arm and progressive breathlessness. Radiological imaging revealed a left sided pleural effusion. Ultrasound guided aspiration revealed a hemorrhagic pleural fluid. A Doppler study of the fistula revealed a high velocity blood flow through the fistula, thereby establishing the cause of the unilateral hemothorax. Ligation of the fistula resulted in complete resolution of the hemothorax. The other possible causes for hemothorax in a dialysis patient are also discussed in this case report.

No MeSH data available.


Related in: MedlinePlus